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What Is Health Insurance Portability?

These days, almost everyone is aware of the importance of a health insurance policy. It can come in very handy in case of medical emergencies, operations and expensive treatments. Now, health insurance portability is something that you should know about too. It allows a policyholder to switch from one insurer to another or from one plan to another of the same insurer. However, this can only be done provided the previous policy has been maintained without any breaks.

Here is everything you need to know about health insurance portability.

What is the Process?

You can apply for health insurance portability with the new insurer as soon as your existing policy is due for renewal (within 45-60 days before the renewal date). The new insurance company will provide you with a proposal form, a portability form, and details of various products offered by it.

The new insurance company will get in touch with your existing insurer once you submit all filled in forms to obtain the medical records and claim history. On your part, you should write to your old insurance company, requesting a shift at least 45 days before your renewal is due.

As per Insurance Regulatory and Development Authority of India (IRDA) regulations, the existing insurer must furnish the details within seven working days through a common data sharing portal developed by IRDA. The new insurer will have to take a decision about underwriting the policy within 15 days once it obtains these details.

In the event the new insurer fails to take a decision within 15 days, it will be bound to accept the application by default.

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When Should You Consider Health Insurance Portability?

You can usually consider health insurance portability, when your current insurer poses the following problems:

  • Inadequate cover for certain health issues and late reimbursements
  • Poor service with slow or hassle-some claim settlement
  • Hike in premiums
  • Limits on room rent
  • Lack of transparency or in other words, hidden clauses and conditions

You should also consider porting your health insurance coverage if you get better deals and economical offerings from another health insurance provider or you have a desire to move to a better insurance company that provides specialized services.

Benefits of Health Insurance Portability

There are many ways porting health insurance can help you:

  • You can get the chance to modify your current policy as per your recent lifestyle changes or present health conditions. You can also go for extra cover and add nominees.
  • The new sum insured will be calculated by adding the bonus accumulated to the existing sum insured. The No Claim Bonus will also be added.
  • Since health insurance is a competitive sector, companies will want to offer you the existing benefits at lesser premiums. This can help you save quite a bit of money.
  • Another benefit is that you can opt for portability without fretting about time bound exclusions. This is because all the benefits offered by your old policy will remain in effect even after the porting is complete.

Things to Note about Health Insurance Portability

You can go for portability only when it is time for your current health insurance policy to be renewed. You will be able to port to similar kinds of policies only. If you require additional benefits while porting, you might have to pay a higher premium. Also, if you are planning to port from a group insurance policy to an individual policy, you might lose out on some of the benefits that were included in the old policy.

What are Your Health Insurance Portability Rights?

IRDA states that no policy-holder should lose the benefits they have accumulated while changing their health insurance policy from one insurance company to another.

Other rights include:

  • Porting a policy from any general insurance company to specialised Health Insurance Company
  • Porting both individual and family policies
  • The new insurer must provide credit for the waiting period for pre-existing conditions that were gained with the old insurer
  • The new insurer must insure up to the sum (at least) insured under the old policy
  • Porting should be completed by the two insurers as per timelines prescribed in the IRDA (Protection of Policyholders’ Interests) regulations and guidelines

It is important to note that only similar health policies can be ported. For instance, you cannot switch to a top-up plan from a reimbursement plan. IRDA does not allow porting of policies that have had breaks due to non-payment or other reasons.

The Final Word

Health Insurance Portability was introduced in 2011 by IRDA and since then has allowed multiple policyholders to change/modify the current policy as per their current health condition/requirements and lifestyle changes. It is important to note that porting comes with its own set of drawbacks. You may lose some benefits if you decide to move from a group insurance policy to individual policy for instance. However, there are many benefits as well, so you should take a call based on your individual situation.